Hemodynamic effects of constant csf volume during spinal anesthesia for cesarean section [Elekti̇f sezaryene yöneli̇k spi̇nal anestezi̇de bos hacmi̇ni̇n korunmasinin hemodi̇nami̇k etki̇leri̇]

Objective: spinal anesthesia is commonly used in emergency and elective cesarean section because it provides rapid and adequate anesthesia. however,hypotension occurs in 40-85% patients after this type of anesthesia. subarachnoid volume can be increased by spinal anesthesia besides increasing intra-abdominal pressure and narrowing subarachnoid space. it was aimed in this study to evaluate the effect of spinal anesthesia with constant subarachnoid volume by aspirating cerebrospinal fluid (csf) on maternal hemodynamics and fetus during cesarean section. method: under sterile condition,subarachnoid space was reached at l4-l5 or l3-l4 intervertebral space with 25g quinche blade spinal needle. after aspirating 2.4 ml csf,12 mg (2.4 ml) bupivacaine heavy was injected into subarachroid space in group a (n=32). in group b (n=33) only 12 mg (2.4 ml) bupivacaine heavy was injected subarachnoid space,without any csf lost. results: the time of reaching maximal sensory block was shorter significantly in group b (p<0,05). at the evaluations of blood gases of both uterine artery and uterine venous,mean ph value were lower significantly in group b (p<0,05). ephedrine usage until birth was lower but not statistically different in group a (p>0,05). cumulative ephedrine usage is similar in both groups. conclusion: taking csf with the amount of planned administration of local anesthetic before subarachnoid injection decreases both risk of maternal hypotension and ephedrine usage till birth and may contribute the well conditions of fetus and baby.